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Li T, Li J, Hu Z, Lu M. An ultrasound based method for predicting the malignant potential of primary gastrointestinal stromal tumors preoperatively. Abdom Radiol (NY) 2024:10.1007/s00261-024-04341-5. [PMID: 38849537 DOI: 10.1007/s00261-024-04341-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 04/12/2024] [Accepted: 04/15/2024] [Indexed: 06/09/2024]
Abstract
OBJECTIVE Gastrointestinal stromal tumors (GISTs) are difficult to identify the risk level accurately without surgical pathological confirmation. The purpose of our study was to propose a noninvasive prediction method for predicting the malignant potential of GISTs preoperatively by using contrast-enhanced ultrasound (CEUS) with gastric distention. METHODS We reviewed 47 GISTs who underwent CEUS from April 2017 to August 2023 retrospectively, all the lesions were certificated by pathology after surgery. The age of the patient, size of the lesion, shape, necrosis, calcification in the lesion, perfusion parameters including arrival time (AT), peak intensity (PI), time to peak (TTP), and area under the curve (AUC) of the lesion and surrounding normal tissue were analyzed. Logistic regression analyses were performed. Of the 47 GISTs, 26 were high-risk and 21 low-risk tumors respectively. RESULTS Compared with low-risk GISTs, high-risk GIST had faster AT (7.7s vs. 11.5s, p < 0.05), higher PI (15.2dB vs. 12.5dB, p < 0.05), and larger size (4.4 cm vs. 2.2 cm, p < 0.001). In multivariate logistic regression, AT, PI, and size were significant features. The corresponding regression equation In (p/(1-p)=-5.9 + 4.5 size + 4.6 PI + 4.0 AT). CONCLUSION The size, AT, and PI of the GISTs on CEUS can be used as parameters for a noninvasive risk level prediction model of GISTs. This model may help identify the different risk levels of GISTs before surgery.
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Affiliation(s)
- Tingting Li
- Department of Ultrasound, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Juan Li
- Department of Ultrasound, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - ZiYue Hu
- Department of Ultrasound, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Man Lu
- Department of Ultrasound, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China.
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Shentu W, Zhang Y, Gu J, Wang F, Zhao W, Liu C, Lin Z, Wang Y, Liu C, Chen Y, Fan Q, Wang H. Contrast-enhanced ultrasonography for differential diagnosis of adnexal masses. Front Oncol 2022; 12:968759. [PMID: 36338700 PMCID: PMC9632442 DOI: 10.3389/fonc.2022.968759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 09/23/2022] [Indexed: 11/23/2022] Open
Abstract
Background Quantitative contrast-enhanced ultrasonography parameters are affected by various factors. We evaluated corrected quantitative contrast enhanced ultrasonography in differentiating benign adnexal tumors from malignant tumors. Methods Patients with adnexal masses who underwent conventional and contrast-enhanced ultrasonography were included. Contrast-enhanced ultrasonography parameters such as base intensity, arrival time, peak intensity, time to peak intensity, ascending slope, and descending slope were measured. Corrected (time to peak intensity − arrival time) mass/(time to peak intensity − arrival time) uterus and (peak intensity − base intensity) mass/(peak intensity − base intensity) uterus were calculated. Lesions were confirmed by pathologic examination of surgical specimens. Results This study included 31 patients with 35 adnexal lesions including 20 (57.10%) benign and 15 (42.90%) malignant lesions. The corrected contrast-enhanced ultrasonography quantitative parameters in lesions were statistically different between malignant and benign groups (P<0.05). The optimal cut-off value for (time to peak intensity − arrival time) mass/(time to peak intensity − arrival time) uterus, ascending slope, and (peak intensity − base intensity) mass/(peak intensity − base intensity) uterus, and descending slope for differentiating malignant adnexal masses from benign tumors were 1.05 (area under curve: 0.93, P<0.05), 1.11 (area under curve: 0.83, P<0.05), 0.82 (area under curve: 0.73, P<0.05), and −0.27 (area under curve: 0.66, P=0.16), with sensitivity and specificity of 93.33% and 85.00%, 86.67% and 75.00%, 86.67% and 60.00%, and 54.55% and 66.67%, respectively. Conclusions Corrected contrast-enhanced ultrasonography parameters provide practical differential diagnosis value of adnexal lesions with high reliability for sonologists.
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Affiliation(s)
- Weihui Shentu
- Department of Medical Ultrasonics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Yin Zhang
- Department of Medical Ultrasonics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Jiaojiao Gu
- Department of Medical Ultrasonics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Fa Wang
- Department of Medical Ultrasonics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Wei Zhao
- Department of Medical Ultrasonics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Chunmei Liu
- Department of Medical Ultrasonics, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Zimei Lin
- Department of Medical Ultrasonics, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Yao Wang
- Department of Medical Ultrasonics, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Chen Liu
- Department of Medical Ultrasonics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Yunyu Chen
- Department of Medical Ultrasonics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
- *Correspondence: Yunyu Chen, ; Qiyun Fan, ; Hongying Wang,
| | - Qiyun Fan
- Department of Medical Ultrasonics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
- *Correspondence: Yunyu Chen, ; Qiyun Fan, ; Hongying Wang,
| | - Hongying Wang
- Department of Medical Ultrasonics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
- *Correspondence: Yunyu Chen, ; Qiyun Fan, ; Hongying Wang,
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Xu L, Wang X, Wu W, Li Y. Diagnostic Accuracy of Double Contrast-Enhanced Ultrasonography in Clarifying Tumor Depth (T Stage) of Gastric Cancer: Meta-analysis. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:2483-2493. [PMID: 34172338 DOI: 10.1016/j.ultrasmedbio.2021.05.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 05/14/2021] [Accepted: 05/17/2021] [Indexed: 06/13/2023]
Abstract
This study aimed to quantitatively analyze published data regarding the ability of double contrast-enhanced ultrasonography (DCEUS) to clarify tumor depth (T stage) in primary gastric carcinoma patients. We obtained six studies, including 926 gastric cancer (GC) patients who were diagnosed by DCEUS from the Cochrane Library "Cochrane Central Register of Controlled Trials (CENTRAL)," OVID MEDLINE, EMBASE, PUBMED and EBSCOhost, to 2019. Sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), forest plot analysis and summary receiver operating characteristic (SROC) curve analysis were used to evaluate the diagnostic accuracy of DCEUS. In our study, all the patients were examined by DCEUS. The quality of all included studies was good. The meta-analysis of six studies (n = 926) revealed that the summary sensitivity and specificity of DCEUS in discriminating T1-T2 versus T3-T4 gastric carcinomas were 0.94 and 0.91, respectively. The pooled sensitivity and specificity of DCEUS were 0.67 and 0.98 for T1 stage, 0.81 and 0.95 for T2 stage, 0.89 and 0.86 for T3 stage and 0.87 and 0.96 for T4 stage, respectively. The SROC curve revealed that the areas under the curve (AUC) of T1-T2 were 0.97 for each stage and 0.82 (T1), 0.84 (T2), 0.91 (T3) and 0.97 (T4). These results indicate that the accuracy of DCEUS in discriminating T1-T2 is higher than that in discriminating T3-T4, and the diagnostic value of DCEUS in discriminating the T3 stage requires further consideration. Finally, our analysis suggested that the diagnostic accuracy of DCEUS is available to guide surgeons in the pre-operative diagnosis of GC patients for more precise treatment.
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Affiliation(s)
- Lifeng Xu
- Department of General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China; Department of General Surgery, Anhui Second Provincial People's Hospital, Hefei, Anhui, People's Republic of China
| | - Xiaodong Wang
- Department of General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Wenzhou Wu
- Department of General Surgery, Anhui Second Provincial People's Hospital, Hefei, Anhui, People's Republic of China
| | - Yongxiang Li
- Department of General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China.
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Tingting LMD, Xiaoyan LMD, Man LMD, Ji-Bin LMD, Wenming LMD, Lixue YMD, Changjun WMD, Zhiqing CMD, Guangxia WMD, Liying MMD, Jingyu WMD, Dong XMD, Jianqiang MMD, Jin YMD, Kang WMD, Zhi DMD, Ling GMD, Lina TMD, Shengjun MMD, Yinrong CMD, Kairong LMD, Yanfang ZMD, Xingxing DMD, Xuemei HMD, Xiaoxia DMD, Yuan LMD, Lu WMD. Chinese Expert Consensus and Guidelines on Oral Contrast Gastric Ultrasonography for Scanning Technique and Imaging Acquisition. ADVANCED ULTRASOUND IN DIAGNOSIS AND THERAPY 2020. [DOI: 10.37015/audt.2020.200061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Assessment of angiogenesis in rabbit orthotropic liver tumors using three-dimensional dynamic contrast-enhanced ultrasound compared with two-dimensional DCE-US. Jpn J Radiol 2019; 37:701-709. [PMID: 31401722 DOI: 10.1007/s11604-019-00861-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 07/26/2019] [Indexed: 12/23/2022]
Abstract
OBJECTIVES To evaluate quantitative three-dimensional (3D) dynamic contrast-enhanced ultrasound (DCE-US) in the assessment of tumor angiogenesis using an orthotropic liver tumor model. METHODS Nine New Zealand white rabbits with liver orthotropic VX2 tumors were established and imaged by two-dimensional (2D) and 3D DCE-US after SonoVue® bolus injections. The intraclass correlation coefficients of perfusion parameters, including peak intensity (PI), mean transit time, time to peak, and area under the curve, were calculated based on time-intensity curve. The percentage area of microvascular (PAMV) and the expression of vascular endothelial growth factor (VEGF) were both evaluated by immunohistochemical analysis and weighted by the tumor activity area ratio. Correlations between quantitative and histologic parameters were analyzed. RESULTS The reproducibility of 3D DCE-US quantitative parameters was excellent (ICC 0.91-0.99); but only PI showed high reproducibility (ICC 0.97) in 2D. None of the parameters of quantitative 2D DCE-US were significantly correlated with weighted PAMV or VEGF. For 3D DCE-US, there was a positive correlation between PI and weighted PAMV (r = 0.74, P = 0.04) as well as VEGF (r = 0.79, P = 0.02). CONCLUSION Quantitative parameters of 3D DCE-US show feasibility, higher reproducibility and accuracy for the assessment of tumor angiogenesis using an orthotropic liver tumor model compared with 2D DCE-US.
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Joo I, Kim SH, Lee DH, Han JK. Dynamic Contrast-Enhanced Ultrasound of Gastric Cancer: Correlation with Perfusion CT and Histopathology. Korean J Radiol 2019; 20:781-790. [PMID: 30993929 PMCID: PMC6470092 DOI: 10.3348/kjr.2018.0273] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 12/10/2018] [Indexed: 02/06/2023] Open
Abstract
Objective To assess the relationship between contrast-enhanced ultrasound (CEUS) parameters and perfusion CT (PCT) parameters of gastric cancers and their correlation with histologic features. Materials and Methods This prospective study was approved by our Institutional Review Board. We included 43 patients with pathologically-proven gastric cancers undergoing CEUS using SonoVue® (Bracco) and PCT on the same day. Correlation between the CEUS parameters (peak intensity [PI], area under the curve [AUC], rise time [RT] from 10% to 90% of PI, time to peak [TTPUS], and mean transit time [MTTUS]) and PCT parameters (blood flow, blood volume, TTPCT, MTTCT, and permeability surface product) of gastric cancers were analyzed using Spearman's rank correlation test. In cases of surgical resection, the CEUS and PCT parameters were compared according to histologic features using Mann-Whitney test. Results CEUS studies were of diagnostic quality in 88.4% (38/43) of patients. Among the CEUS parameters of gastric cancers, RT and TTPUS showed significant positive correlations with TTPCT (rho = 0.327 and 0.374, p = 0.045 and 0.021, respectively); PI and AUC were significantly higher in well-differentiated or moderately-differentiated tumors (n = 4) than poorly-differentiated tumors (n = 18) (p = 0.026 and 0.033, respectively), whereas MTTCT showed significant differences according to histologic types (poorly cohesive carcinoma [PCC] vs. non-PCC), T-staging (≤ T2 vs. ≥ T3), N-staging (N0 vs. N-positive), and epidermal growth factor receptor expression (≤ faint vs. ≥ moderate staining) (p values < 0.05). Conclusion In patients with gastric cancers, CEUS is technically feasible for the quantification of tumor perfusion and may provide correlative and complementary information to that of PCT, which may allow prediction of histologic features.
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Affiliation(s)
- Ijin Joo
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Se Hyung Kim
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
| | - Dong Ho Lee
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Joon Koo Han
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.,Institute of Radiation Medicine, Seoul National University Hospital, Seoul, Korea
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Zhu W, Mai G, Zhou X, Song B. Double contrast-enhanced ultrasound improves the detection and localization of occult lesions in the pancreatic tail: a initial experience report. Abdom Radiol (NY) 2019; 44:559-567. [PMID: 30121778 DOI: 10.1007/s00261-018-1746-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE The aim of this study is to review our initial experience of Double contrast-enhanced ultrasonography (DCEUS) in the preoperative detection of pancreatic tail occult tumors. METHODS Thirty-five patients were recruited to undergo DCEUS of the pancreas suspected by occult lesions of pancreatic with MRI or clinical evidence. The radiologists assessed the images (conventional US, DCEUS, and MRI) for enhancement phases, tumor presence, location, enhancement characteristics, and tumor conspicuity. The differences in the onset times of the phases between DCEUS and MRI were noted. Tumor conspicuity was graded on a four-point scale for conspicuity comparison among three imaging modalities. RESULTS Pancreatic tail tumors were missed on conventional transabdominal US in 11 of 35 patients. DCEUS revealed 12 lesions of 35 patients. Pancreatic tail tumors were identified on MRI in 10 of 35 patients. The sensitivity and specificity of DCEUS for depicting occult lesions of ≤ 2.2 cm were 92% and 95%, respectively. In contrast, the sensitivity and specificity of conventional US were 67% and 66%, respectively. The sensitivity and specificity of MRI were 91% and 88%, respectively. The conspicuity ratings of the three phases did not significantly differ between the DCEUS and MRI groups (P > 0.05). The DCEUS phases started much earlier than the corresponding MRI phases. CONCLUSION DCEUS is a promising technique in the detection of occult pancreatic tail tumors and is possibly superior to dynamic enhanced MRI in the case of some peripheral lesions.
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Affiliation(s)
- Wei Zhu
- Echo Lab of Cardiology, Department/Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Gang Mai
- Department of Hepatobiliopancreatic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xiang Zhou
- Department of Interventional Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
| | - Bin Song
- Radiology Department, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Guo S, Xu P, Zhou A, Wang G, Chen W, Mei J, Xiao F, Liu J, Zhang C. Contrast-Enhanced Ultrasound Differentiation Between Low- and High- Grade Bladder Urothelial Carcinoma and Correlation With Tumor Microvessel Density. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2017; 36:2287-2297. [PMID: 28556470 DOI: 10.1002/jum.14262] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 02/09/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES Time-intensity curves (TICs) of contrast-enhanced ultrasound (CEUS) were analyzed retrospectively to differentiate between low-grade and high-grade bladder urothelial carcinoma, and to investigate correlation with tumor microvessel density (MVD). METHODS The data of 105 patients with pathologically confirmed bladder urothelial carcinoma (55 low-grade and 50 high-grade) were reviewed. Lesions were examined before surgery using conventional ultrasound and CEUS with TIC analysis. The TIC parameters time from peak to one-half the signal intensity (TPH) and the corresponding descending slope (DS) of the low-grade and high-grade groups were compared, and receiver operating characteristic curves constructed. The MVDs of the resectioned tissue specimens were quantified via immunohistochemistry for CD34. RESULTS Based on conventional ultrasound, the low-grade and high-grade groups were similar in tumor shape, number, topography, internal echo, height, width, and vascularity. The TPH of the high-grade group was significantly longer than that of the low-grade group, and the DS was lower. The cutoff points of TPH and DS for differentiating low-grade and high-grade bladder urothelial carcinoma were 48.06 seconds and 0.15 dB/seconds, respectively (area under the receiver operating characteristic curve = 0.79 for both). The mean MVDs per high-power field of the low-grade and high-grade groups were 41.39 16.65 and 51.03 20.16, respectively (P = .009). The TPH correlated linearly with MVD (P < .01), as did the DS (P < .01). CONCLUSIONS Contrast-enhanced ultrasound can be used to differentiate low from high-grade bladder urothelial carcinoma. The TIC parameters of CEUS reflect the MVD of bladder urothelial tumors and may be helpful for evaluating tumor angiogenesis, with implications for clinical diagnosis, treatment, and prognosis.
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Affiliation(s)
- Suping Guo
- Department of Ultrasonography, First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Pan Xu
- Department of Ultrasonography, First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Aiyun Zhou
- Department of Ultrasonography, First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Gongxian Wang
- Department of Urology Surgery, First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Weimin Chen
- Department of Ultrasonography, First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jinhong Mei
- Department of Pathology, First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Fan Xiao
- Department of Ultrasonography, First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Juan Liu
- Department of Ultrasonography, First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Cheng Zhang
- Department of Ultrasonography, First Affiliated Hospital of Nanchang University, Nanchang, China
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Lv X, Hou M, Duan X. Correlation analysis between the parameters of contrast-enhanced ultrasonography in evaluating cervical cancer metastasis and expression of E-cadherin. Oncol Lett 2017; 14:4641-4646. [PMID: 29085462 PMCID: PMC5649574 DOI: 10.3892/ol.2017.6785] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 08/08/2017] [Indexed: 12/15/2022] Open
Abstract
The study aims to investigate the correlation between the parameters of contrast-enhanced ultrasonography in evaluating cervical cancer metastasis and expression of E-cadherin. All 120 patients with cervical cancer underwent contrast-enhanced ultrasonography. According to the results of postoperative pathological examination, patients were divided into distant metastasis group (group A), lymph node metastasis without distant metastasis group (group B) and no metastasis group (group C). Expression of E-cadherin in cervical cancer tissues was detected by enzyme-linked immunosorbent assay (ELISA). Correlations between the parameters of contrast-enhanced ultrasonography in evaluating cervical cancer metastasis and expression of E-cadherin were analyzed by Pearsons correlation analysis. Comparison of parameters of contrast-enhanced ultrasonography showed that, the baseline intensity of group A was 11.9±2.2 dB, which was significantly lower than that of group B and C. Baseline intensity of group B was significantly lower than that of group C (13.0±2.4 vs. 15.3±3.6 dB), significant differences were found among three groups (P<0.05). The sensitivity and specificity of the use of enhanced intensity ~83.7 dB in evaluating tumor metastasis of patients with cervical cancer were 82.42 and 79.32%, respectively. Expression level of E-cadherin protein in group A was 0.030±0.003 ng/ml, which was significantly lower than that in group B and C (P<0.05), expression level of E-cadherin protein in group A was significantly lower than that in group C (0.037±0.007 vs. 0.045±0.012 ng/ml), significant differences in the expression level of E-cadherin protein were found among the three groups of cervical cancer patients (P<0.05). Pearsons correlation analysis showed that there was a positive correlation between the baseline intensity of contrast-enhanced ultrasonography and the expression level of E-cadherin (P<0.05), while there was a negative correlation between the enhanced intensity of contrast-enhanced ultrasonography and the expression level of E-cadherin (P<0.05). Contrast-enhanced ultrasonography can be used to determine the tumor metastasis of cervical cancer patients, in addition, the combined use of contrast-enhanced ultrasonography and E-cadherin protein expression can significantly improve the diagnosis and treatment of cervical cancer.
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Affiliation(s)
- Xiaolan Lv
- Department of Ultrasonography, Affiliated Hospital of Hebei University, Baoding, Hebei 071000, P.R. China
| | - Min Hou
- Department of Ultrasonography, Affiliated Hospital of Hebei University, Baoding, Hebei 071000, P.R. China
| | - Xiaojing Duan
- Department of Ultrasonography, Affiliated Hospital of Hebei University, Baoding, Hebei 071000, P.R. China
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Zhang T, Su ZZ, Wang P, Wu T, Tang W, Xu EJ, Ju JX, Quan XY, Zheng RQ. Double contrast-enhanced ultrasonography in the detection of periampullary cancer: Comparison with B-mode ultrasonography and MR imaging. Eur J Radiol 2016; 85:1993-2000. [DOI: 10.1016/j.ejrad.2016.08.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 08/26/2016] [Indexed: 01/22/2023]
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Liu Y, Xu Y, Cheng W, Liu X. Quantitative contrast-enhanced ultrasonography for the differential diagnosis of endometrial hyperplasia and endometrial neoplasms. Oncol Lett 2016; 12:3763-3770. [PMID: 27895728 PMCID: PMC5104163 DOI: 10.3892/ol.2016.5206] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 09/02/2016] [Indexed: 02/07/2023] Open
Abstract
The present study aimed to investigate the feasibility of applying contrast-enhanced ultrasonography (CEUS) imaging technology for distinguishing between benign and malignant endometrial lesions, and to screen markers that could be correlated with the pathological results. In this study, endometrial diseases were diagnosed by biopsy under hysteroscopy and CEUS examinations. The intensity and time parameters of the time-intensity curve (TIC) were analyzed. The mean arrival time (AT), time-to-peak (TTP), rise time (RT), washout half-time and clearance half-time of malignant lesions were shorter than those of benign lesions (P<0.05), whereas the average peak intensity (PI) and enhancement intensity (EI) of malignant lesions were higher than those of benign lesions (P<0.05). The receiver operating characteristic curve showed the following cut-off values: PI, 29.2 dB; EI, 21.35 dB; AT, 12.75 sec; TTP, 26.75 sec; RT, 13.2 sec; clearance half-time, 89.3 sec; and washout half-time, 75.45 sec. The lesions with PI, an EI higher than that of the cut-off and lesions with an AT, TTP, RT, half clearing time and washout half-time shorter than the cut-off were considered malignant. The TTP, RT and half clearing time were negatively correlated with microvessel density (MVD), i.e., MVD was higher when the TTP, RT and half clearing time were shorter. Overall, changes in the enhancement and clearing of lesions could be quantitatively analyzed by CEUS TIC and further discriminate benign from malignant lesions. In the present study, CEUS appeared to indirectly reflect blood vessel changes inside the lesions and provided a pre-operative non-invasive fast imaging method for the diagnosis of endometrial disease.
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Affiliation(s)
- Ying Liu
- Department of Ultrasound, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang 150081, P.R. China
| | - Yi Xu
- Department of Ultrasound, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang 150081, P.R. China
| | - Wen Cheng
- Department of Ultrasound, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang 150081, P.R. China
| | - Xinghan Liu
- Department of Biochemistry and Molecular Biology, Harbin Medical University, Harbin, Heilongjiang 150081, P.R. China
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Wang S, Yang W, Fu JJ, Sun Y, Zhang H, Bai J, Chen MH, Yan K. Microflow imaging of contrast-enhanced ultrasound for evaluation of neovascularization in peripheral lung cancer. Medicine (Baltimore) 2016; 95:e4361. [PMID: 27512847 PMCID: PMC4985302 DOI: 10.1097/md.0000000000004361] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The aim of this study was to investigate the role of microflow imaging (MFI) of contrast-enhanced ultrasound (CEUS) for evaluating microvascular architecture of different types of peripheral lung cancer (PLC) and to explore the correlated pathological basis.Ninety-five patients with PLC were enrolled in this study. Two radiologists independently evaluated the microvascular architecture of PLC with MFI. The interobserver agreement was measured with Kappa test. The diagnosis value of MFI was calculated. With pathological analysis, the correlation between MFI and microvascular density (MVD)/microvascular diameter (MD) was evaluated.Of the 95 PLCs, MFI were mainly classified "dead wood" (27.4%, 25.3%), "vascular" (47.4%, 49.5%), and "cotton" (20.0%, 20.0%) patterns by the 2 readers. Kappa test showed a good agreement between the 2 readers (Kappa = 0.758). The "dead wood" can be regarded as a specific diagnostic factor for squamous carcinoma; the sensitivity, specificity, and accuracy was 62.9%, 93.3%, and 82.1%, respectively. The "vascular" and "cotton" patterns correlated well with adenocarcinoma and SCLC (small cell lung cancer); diagnostic sensitivity, specificity, and accuracy were 86.7%, 65.7%, and 78.9%, respectively. MVD of "dead wood" was lower than "vascular" and "cotton," while MD was bigger than the other 2 patterns (P < 0.05). There was a good correlation between MFI and histopathological types of PLC as well as between MFI and MVD/MD (P < 0.05).MFI has the advantage to display the microvascular architecture of PLCs and might become a promising diagnostic method of histopathological types of PLC. MFI features also correlated well with its pathological basis, including MVD and MD.
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Affiliation(s)
| | | | | | - Yu Sun
- Department of Pathology, Key Laboratory of Carcinogenesis and Translational Research of Ministry of Education, Peking University, Cancer Hospital & Institute, Beijing, China
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Yan C, Bao X, Shentu W, Chen J, Liu C, Ye Q, Wang L, Tan Y, Huang P. Preoperative Gross Classification of Gastric Adenocarcinoma: Comparison of Double Contrast-Enhanced Ultrasound and Multi-Detector Row CT. ULTRASOUND IN MEDICINE & BIOLOGY 2016; 42:1431-1440. [PMID: 27072076 DOI: 10.1016/j.ultrasmedbio.2016.01.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 12/25/2015] [Accepted: 01/23/2016] [Indexed: 06/05/2023]
Abstract
The aim of this study was to compare the accuracy of multi-detector computed tomography (MDCT) with double contrast-enhanced ultrasound (DCEUS), in which intravenous microbubbles are used alongside oral contrast-enhanced ultrasound, in determining the gross classification of patients with gastric carcinoma (GC). Altogether, 239 patients with GC proved by histology after endoscopic biopsy were included in this study. DCEUS and MDCT were performed pre-operatively. The diagnostic accuracies of DCEUS and MDCT in determining the gross classification were calculated and compared. The overall accuracy of DCEUS in determining the gross appearance of GC was higher than that of MDCT (84.9% vs. 79.9%, p < 0.001). There was no significant difference in accuracy between DCEUS and MDCT for Borrmann I and IV classifications of advanced gastric cancer (χ(2), p = 0.323 for Borrmann type I, p = 0.141 for Borrmann type IV). The accuracy of DCEUS for early GC and Borrmann II and III classifications of GC was higher than that of MDCT (χ(2), p = 0.000 for all). DCEUS may be regarded as a valuable complementary tool to MDCT in determining the gross appearance of gastric adenocarcinoma pre-operatively.
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Affiliation(s)
- Caoxin Yan
- Department of Ultrasound, The 2nd Affiliated Hospital of Zhejiang University College of Medicine, Hangzhou, China
| | - Xiaofeng Bao
- Department of Ultrasound, The 2nd Affiliated Hospital of Zhejiang University College of Medicine, Hangzhou, China
| | - Weihui Shentu
- Department of Ultrasound, The 2nd Affiliated Hospital of Zhejiang University College of Medicine, Hangzhou, China
| | - Jian Chen
- Department of Surgery, The 2nd Affiliated Hospital Zhejiang University College of Medicine, Hangzhou, China
| | - Chunmei Liu
- Department of Ultrasound, The 2nd Affiliated Hospital of Zhejiang University College of Medicine, Hangzhou, China
| | - Qin Ye
- Department of Pathology, The 2nd Affiliated Hospital Zhejiang University College of Medicine, Hangzhou, China
| | - Liuhong Wang
- Department of Radiology, The 2nd Affiliated Hospital Zhejiang University College of Medicine, Hangzhou, China
| | - Yangbin Tan
- Department of Radiology, The 2nd Affiliated Hospital Zhejiang University College of Medicine, Hangzhou, China
| | - Pintong Huang
- Department of Ultrasound, The 2nd Affiliated Hospital of Zhejiang University College of Medicine, Hangzhou, China.
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Jun HY, Ryu JH, Byun SJ, Jeong CW, Kim TH, Lee YH, Yoon KH. Combined Radiofrequency Ablation and Double Anti-Angiogenic Protein Therapy to Increase Coagulation Efficacy: An Experimental Study in a Murine Renal Carcinoma Model. Korean J Radiol 2015; 16:776-82. [PMID: 26175576 PMCID: PMC4499541 DOI: 10.3348/kjr.2015.16.4.776] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 03/18/2015] [Indexed: 11/16/2022] Open
Abstract
Objective To evaluate whether suppression of tumor microvasculature by double anti-angiogenic protein (DAAP) treatment could increase the extent of radiofrequency ablation (RFA)-induced coagulation in a murine renal cell carcinoma model. Materials and Methods Renal cell carcinoma cell lines were implanted subcutaneously into 10 nude mice. Four mice received adenoviral DAAP treatment and 6 mice received sterile 0.9% saline solution as DAAP-untreated group. The effect of DAAP was evaluated according to the vascularity by contrast-enhanced ultrasound (CEUS) using microbubbles. Four DAAP-treated mice and 4 DAAP-untreated mice were then treated with RFA, resulting in 3 groups: no-therapy (n = 2), RFA only (n = 4), and RFA combined with DAAP treatment (n = 4). Immediately after RFA, the size of coagulation necrosis and mitochondrial enzyme activity were compared between the groups using analysis of variance (ANOVA) and post hoc test. Results The contrast enhancement ratio for tumor vascularization on CEUS was significantly lower in the DAAP treated group than in DAAP-untreated group (30.2 ± 9.9% vs. 77.4 ± 17.3%; p = 0.021). After RFA, the mean coagulation diameter was 0 mm for no-therapy group, 6.7 ± 0.7 mm for the RFA only group and 8.5 ± 0.4 mm for the RFA with DAAP group (ANOVA, p < 0.001). The area of viable mitochondria within the tumor was 27.9 ± 3.9% in no-therapy group, 10.3 ± 4.5% in the RFA only group, and 2.1 ± 0.7% in the RFA with DAAP group (ANOVA, p < 0.001). Conclusion Our results suggest the potential value of combining RFA with anti-angiogenic therapy.
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Affiliation(s)
- Hong Young Jun
- Imaging Science Research Center, Wonkwang University School of Medicine, Iksan 570-711, Korea
| | - Jong-Hyun Ryu
- Imaging Science Research Center, Wonkwang University School of Medicine, Iksan 570-711, Korea
| | - Seung Jae Byun
- Department of Surgery, Wonkwang University School of Medicine, Iksan 570-711, Korea
| | - Chang Won Jeong
- Imaging Science Research Center, Wonkwang University School of Medicine, Iksan 570-711, Korea
| | - Tae-Hoon Kim
- Imaging Science Research Center, Wonkwang University School of Medicine, Iksan 570-711, Korea
| | - Young Hwan Lee
- Department of Radiology, Wonkwang University School of Medicine, Iksan 570-711, Korea
| | - Kwon-Ha Yoon
- Imaging Science Research Center, Wonkwang University School of Medicine, Iksan 570-711, Korea. ; Department of Radiology, Wonkwang University School of Medicine, Iksan 570-711, Korea
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Tian N, Qu YW, Liu HF. Targeted ultrasound microbubble contrast agents for enhanced tumor imaging. Shijie Huaren Xiaohua Zazhi 2014; 22:5100-5105. [DOI: 10.11569/wcjd.v22.i33.5100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
In the field of medical ultrasound, ultrasound microbubbles are a new class of ultrasound contrast agents. Ultrasound microbubbles can be divided into two types: ordinary and targeted microbubbles. Ordinary microbubbles have been widely used in clinical practice. Targeted microbubbles are a special class of contrast agents and can be divided into micron- and nano-scale targeted microbubbles according to particle size. The former cannot pass through the endothelial gap due to the larger particle size, while the latter can pass through the vascular endothelium and allows for imaging of the extravascular tissues. Ultrasound combined with targeted microbubbles in enhancing tumor imaging shows greater advantages and has become an important topic of research; however, its unknown toxicity limits its wider application. In addition, ultrasound parameters still need to be optimized.
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Li SY, Huang PT, Xu HS, Liang X, Lv JH, Zhang Y, Cai XJ, Cosgrove D. Enhanced intensity on preoperative double contrast-enhanced sonography as a useful indicator of lymph node metastasis in patients with gastric cancer. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2014; 33:1773-1781. [PMID: 25253823 DOI: 10.7863/ultra.33.10.1773] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVES The aim of this study was to investigate the predictive value of enhanced intensity on double contrast-enhanced sonography in assessing lymph node metastasis of gastric cancer. METHODS A total of 357 patients with gastric cancer were enrolled in this study. Double contrast-enhanced sonography, in which an oral ultrasound contrast agent is combined with an intravenous contrast agent, was performed preoperatively, and the data were analyzed quantitatively. The predictive ability of enhanced intensity, a quantitative double contrast-enhanced sonographic measure, for lymph node metastasis was evaluated retrospectively. RESULTS Compared to negative lymph node metastasis cases, the presence of thicker lesions, deeper invasion, poorer differentiation, and higher enhanced intensity were found in positive cases (P< .05). An enhanced intensity cutoff value of 16.91 dB was the best point for balancing the sensitivity and specificity (71.50% and 79.30%, respectively) for prediction of lymph node metastasis, with the highest Youden index of 0.508. The area under the receiver operating characteristic curve was 0.828 (P < .001; 95% confidence interval, 0.786-0.870). In cases in which the lesions were hyperenhanced (enhanced intensity >16.91 dB), the lesions were significantly thicker and had deeper invasion, poorer differentiation, and more positive metastasis findings compared to non-hyperenhanced cases (enhanced intensity ≤16.91 dB; P < .05). On logistic regression analysis, the enhanced intensity of primary tumors and the invasion depth were significantly associated with lymph node metastasis. CONCLUSIONS Double contrast-enhanced sonography with quantitative analysis may be considered a novel alternative imaging modality for noninvasive preoperative evaluation of lymph node metastasis with good reliability.
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Affiliation(s)
- Shi-Yan Li
- Department of Diagnostic Ultrasound and Echocardiography (S.L., H.X., J.L.) and Second Department of General Surgery (X.L., X.C.), Sir Run Run Shaw Hospital, Zhejiang University College of Medicine, Hangzhou, China; Department of Ultrasonography, Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, China (P.H., Y.Z.); and Imaging Sciences Department, Imperial College, Hammersmith Hospital, London, England (D.C.)
| | - Pin-Tong Huang
- Department of Diagnostic Ultrasound and Echocardiography (S.L., H.X., J.L.) and Second Department of General Surgery (X.L., X.C.), Sir Run Run Shaw Hospital, Zhejiang University College of Medicine, Hangzhou, China; Department of Ultrasonography, Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, China (P.H., Y.Z.); and Imaging Sciences Department, Imperial College, Hammersmith Hospital, London, England (D.C.)
| | - Hai-Shan Xu
- Department of Diagnostic Ultrasound and Echocardiography (S.L., H.X., J.L.) and Second Department of General Surgery (X.L., X.C.), Sir Run Run Shaw Hospital, Zhejiang University College of Medicine, Hangzhou, China; Department of Ultrasonography, Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, China (P.H., Y.Z.); and Imaging Sciences Department, Imperial College, Hammersmith Hospital, London, England (D.C.)
| | - Xiao Liang
- Department of Diagnostic Ultrasound and Echocardiography (S.L., H.X., J.L.) and Second Department of General Surgery (X.L., X.C.), Sir Run Run Shaw Hospital, Zhejiang University College of Medicine, Hangzhou, China; Department of Ultrasonography, Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, China (P.H., Y.Z.); and Imaging Sciences Department, Imperial College, Hammersmith Hospital, London, England (D.C.)
| | - Jiang-Hong Lv
- Department of Diagnostic Ultrasound and Echocardiography (S.L., H.X., J.L.) and Second Department of General Surgery (X.L., X.C.), Sir Run Run Shaw Hospital, Zhejiang University College of Medicine, Hangzhou, China; Department of Ultrasonography, Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, China (P.H., Y.Z.); and Imaging Sciences Department, Imperial College, Hammersmith Hospital, London, England (D.C.)
| | - Ying Zhang
- Department of Diagnostic Ultrasound and Echocardiography (S.L., H.X., J.L.) and Second Department of General Surgery (X.L., X.C.), Sir Run Run Shaw Hospital, Zhejiang University College of Medicine, Hangzhou, China; Department of Ultrasonography, Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, China (P.H., Y.Z.); and Imaging Sciences Department, Imperial College, Hammersmith Hospital, London, England (D.C.)
| | - Xiu-Jun Cai
- Department of Diagnostic Ultrasound and Echocardiography (S.L., H.X., J.L.) and Second Department of General Surgery (X.L., X.C.), Sir Run Run Shaw Hospital, Zhejiang University College of Medicine, Hangzhou, China; Department of Ultrasonography, Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, China (P.H., Y.Z.); and Imaging Sciences Department, Imperial College, Hammersmith Hospital, London, England (D.C.).
| | - David Cosgrove
- Department of Diagnostic Ultrasound and Echocardiography (S.L., H.X., J.L.) and Second Department of General Surgery (X.L., X.C.), Sir Run Run Shaw Hospital, Zhejiang University College of Medicine, Hangzhou, China; Department of Ultrasonography, Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, China (P.H., Y.Z.); and Imaging Sciences Department, Imperial College, Hammersmith Hospital, London, England (D.C.)
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Qi-hua X, Chen Z, Jian-gang Z, Da-zhong Z, Yong-qiang Z. Comparison of contrast-enhanced ultrasonography and contrast-enhanced MRI for the assessment of vascularization of hydroxyapatite orbital implants. Clin Imaging 2014; 38:616-20. [DOI: 10.1016/j.clinimag.2014.05.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2013] [Revised: 04/24/2014] [Accepted: 05/13/2014] [Indexed: 10/25/2022]
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Time-intensity curve parameters in rectal cancer measured using endorectal ultrasonography with sterile coupling gels filling the rectum: correlations with tumor angiogenesis and clinicopathological features. BIOMED RESEARCH INTERNATIONAL 2014; 2014:587806. [PMID: 24900973 PMCID: PMC4036556 DOI: 10.1155/2014/587806] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2014] [Accepted: 04/20/2014] [Indexed: 02/08/2023]
Abstract
The primary aim of this study was to investigate the relationship between contrast-enhanced ultrasonography (CEUS) imaging parameters and clinicopathological features of rectal carcinoma and assess their potential as new radiological prognostic predictors. A total of 66 rectal carcinoma patients were analyzed with the time-intensity curve of CEUS. The parameter arrival time (AT), time to peak enhancement (TTP), wash-in time (WIT), enhanced intensity (EI), and ascending slope (AS) were measured. Microvessel density (MVD) was evaluated by immunohistochemical staining of surgical specimens. All findings were analysed prospectively and correlated with tumor staging, histological grading, and MVD. The mean values of AT, TTP, WIT, EI, and AS value of the rectal carcinoma were 10.84 ± 3.28 s, 20.61 ± 5.52 s, 9.78 ± 2.83 s, 28.68 ± 4.67 dB, and 3.20 ± 1.10, respectively. A positive linear correlation was found between the EI and MVD in rectal carcinoma (r = 0.295, P = 0.016), and there was a significant difference for EI among histological grading (r = -0.264, P = 0.007). EI decreased as T stage increased with a trend of association noted (P = 0.096). EI of contrast enhanced endorectal ultrasonography provides noninvasive biomarker of tumor angiogenesis in rectal cancer. CEUS data have the potential to predict patient prognosis.
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Lu M, Yan B, Song J, Ping W, Yue LX, Song B. Double-contrast-enhanced sonography for diagnosis of rectal lesions with pathologic correlation. JOURNAL OF ULTRASOUND IN MEDICINE 2014; 33:575-83. [PMID: 24658937 DOI: 10.7863/ultra.33.4.575] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Transabdominal sonography with a gastrointestinal contrast agent has been widely used in China for investigation of digestive disorders. Double-contrast-enhanced sonography combines a gastrointestinal luminal contrast agent with an intravenous contrast agent for imaging of lesions. The purpose of this pilot study was to assess the value of double-contrast-enhanced sonography for preoperative diagnosis of rectal lesions. METHODS We conducted a prospective single-center study using double-contrast-enhanced sonography of rectal lesions. Patients were administered both rectal and intravenous contrast agents, and imaging was performed transabdominally, transanally, and transrectally. Morphologic characteristics and perfusion parameters were compared between histologically proven adenocarcinomas, adenomas, and inflammatory masses. Perfusion parameters were analyzed with time-intensity curves, measuring the contrast arrival time, time to peak, peak intensity, and area under the curve of the lesions and normal rectal tissue. RESULTS From January 2009 to September 2012, 420 patients were recruited, with 227 patients meeting inclusion/exclusion criteria and having 232 rectal lesions analyzed (172 rectal adenocarcinomas, 45 adenomas, and 15 inflammatory masses). Adenocarcinomas had variable enhancement patterns. Adenomas were all hypoenhanced in a homogeneous pattern. Inflammatory masses had a hyperenhanced rim with no central enhancement. Time-intensity curve perfusion parameters (arrival time, time to peak, peak intensity, and area under the curve) of rectal adenocarcinomas, adenomas, and inflammatory masses were significantly different compared to normal rectal tissue (P < .05). The differences in the arrival time, peak intensity, and time to peak among the different lesions were also significant (P < .05). CONCLUSIONS Double-contrast-enhanced sonographic assessment of morphologic enhancement patterns combined with vascularity parameters may help differentiate benign and malignant rectal lesions.
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Affiliation(s)
- Man Lu
- Department of Radiology, West China Hospital of Sichuan University, 37 Guo Xue Xiang 610041 Chengdu, Sichuan, China.
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Pan M, Huang P, Li S, Chen J, Wei S, Zhang Y. Double contrast-enhanced ultrasonography in preoperative Borrmann classification of advanced gastric carcinoma: comparison with histopathology. Sci Rep 2013; 3:3338. [PMID: 24275807 PMCID: PMC3840384 DOI: 10.1038/srep03338] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Accepted: 11/11/2013] [Indexed: 02/07/2023] Open
Abstract
The purpose of this study was to investigate the accuracy of double contrast-enhanced ultrasonography (DCEUS) for assessing the Borrmann classification of advanced gastric carcinoma (AGC) preoperatively. Three hundred twenty nine patients with proved AGC were enrolled. DCEUS (intravenous microbubbles combined with combined with oral contrast-enhanced ultrasound) was performed preoperatively. The diagnostic accuracy of DCEUS in determining Borrmann classification was compared with postoperative pathological findings. The reliability of DCEUS was analyzed. The accuracy of DCEUS in determining the Borrmann classification of AGC was 91.49%. The intra- and inter-observer reproducibility was both almost perfect for assessing the Borrmann classification of AGC by DCEUS. DCEUS could be considered as an accurate, non-invasive, and reliable diagnostic method for preoperative Borrmann classification of advanced gastric carcinoma.
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Affiliation(s)
- Minqiang Pan
- Department of Ultrasonography, the 2nd Affiliated Hospital Zhejiang University College of Medicine, Hangzhou, China
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Wei F, Huang P, Li S, Chen J, Zhang Y, Hong Y, Wei S, Cosgrove D. Enhancement patterns of gastric carcinoma on contrast-enhanced ultrasonography: relationship with clinicopathological features. PLoS One 2013; 8:e73050. [PMID: 24039857 PMCID: PMC3765212 DOI: 10.1371/journal.pone.0073050] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Accepted: 07/16/2013] [Indexed: 12/29/2022] Open
Abstract
The aim of this study was to assess the relationship between the enhancement patterns and clinicopathological features of gastric cancer using intravenous contrast-enhanced ultrasonography (CEUS). In this Ethics Committee-approved prospective study, five hundred fifty two patients with gastric cancer who gave informed consent were examined preoperatively with CEUS. The enhancement pattern of each tumor was analyzed visually. Gross and histopathological findings on the postoperative specimens were compared with the preoperative CEUS findings. The most common CEUS pattern in differentiated gastric cancer was homogeneous enhancement, whereas heterogeneous enhancement was the most common pattern in undifferentiated gastric cancer. The proportion of heterogeneous enhancement was significantly different between the two histological subtypes (Chi- square = 146.735, P<0.001). The sensitivity and specificity of early heterogeneous enhancement on CEUS in diagnosing undifferentiated gastric cancer were 78.84% and 72.59% respectively. Gastric cancers with heterogeneous enhancement were more often Borrmann III and IV macroscopic types than those with homogeneous enhancement (66.56% vs. 30.80%, P<0.001), more commonly T3 and T4 depth of invasion than those with homogeneous enhancement (71.52% vs. 59.60%, P<0.05), more often showed lymphatic invasion than those with homogeneous enhancement (84.44% vs. 76.40%, P<0.05), and were less likely to receive curative gastrectomy than those with homogeneous enhancement (74.83% vs. 86.40%, P<0.005). The intra- and inter-observer reproducibility were both almost perfect for assessing enhancement patterns, with Kappa values of 0.916 (P<0.001) for intra-observer and 0.842 (P<0.001) for inter-observer reproducibility. CEUS provided detailed information about tumor vascularity and contrast enhancement patterns in gastric cancer. CEUS is promising as a new and useful method to predict the histological type of gastric cancer.
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Affiliation(s)
- Fang Wei
- Department of Ultrasound, The 2nd Affiliated Hospital of Zhejiang University College of Medicine, Hangzhou, China
| | - Pintong Huang
- Department of Ultrasound, The 2nd Affiliated Hospital of Zhejiang University College of Medicine, Hangzhou, China
- * E-mail:
| | - Shiyan Li
- Department of Diagnostic Ultrasound and Echocardiography, Sir Run Run Shaw Hospital, Zhejiang University College of Medicine, Hangzhou, China
| | - Jian Chen
- Department of Surgery, The 2nd Affiliated Hospital of Zhejiang University College of Medicine, Hangzhou, China
| | - Ying Zhang
- Department of Ultrasound, The 2nd Affiliated Hospital of Zhejiang University College of Medicine, Hangzhou, China
| | - Yurong Hong
- Department of Ultrasound, The 2nd Affiliated Hospital of Zhejiang University College of Medicine, Hangzhou, China
| | - Shumei Wei
- Department of Pathology, The 2nd Affiliated Hospital of Zhejiang University College of Medicine, Hangzhou, China
| | - David Cosgrove
- Imaging Sciences Department, Imperial College, Hammersmith Hospital, London, United Kingdom
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Zhang HP, Shi QS, Li F, Liu L, Bai M, Gu JY, Wu Y, Du LF. Regions of interest and parameters for the quantitative analysis of contrast-enhanced ultrasound to evaluate the anti-angiogenic effects of bevacizumab. Mol Med Rep 2013; 8:154-60. [PMID: 23722237 DOI: 10.3892/mmr.2013.1499] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Accepted: 05/02/2013] [Indexed: 11/05/2022] Open
Abstract
The aim of the present study was to identify effective regions of interest (ROIs) and parameters for the quantitative analysis of contrast-enhanced ultrasound (CEUS) to evaluate the anti-angiogenic effects of bevacizumab. Thirty mice were subcutaneously injected with CT26 cells and randomly divided into a bevacizumab‑treated (Bev) group and a control group (normal saline-treated). CEUS and quantitative analysis were performed on days 7, 11, 14 and 21 following tumor establishment. ROItotal, which included the whole tumor, and ROIsmall, which included the most enhanced part of the tumor, were selected and outlined. Parameters including time to peak (TTP), maximum intensity (Imax) and area under the curve (AUC; in addition to rates of AUC1, AUC2, AUCfast and AUCslow) were recorded. The tumors were resected on day 21 for microvessel density (MVD) counting. Our results showed that the MVD in the Bev group was significantly lower compared with that in the control group (4.09 vs. 6.41; P=0.001). Additional parameters of ROIsmall were identified to be significantly different between the two groups, compared with those of ROItotal. No significant differences in TTP and Imax were observed between the two groups at the four time‑points examined (P>0.05). For the AUC parameters in ROIsmall, AUC and the rates of AUC2, AUCfast and AUCslow were lower in the Bev group compared with those in the control group on days 7 and 11 (P<0.05). These findings indicate that ROIsmall and AUC parameters in the quantitative analysis of CEUS may be useful for the evaluation of changes in tumor angiogenesis following bevacizumab treatment.
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Affiliation(s)
- Hui-Ping Zhang
- Department of Ultrasound, First People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200080, PR China
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Shi H, Yu XH, Guo XZ, Guo Y, Zhang H, Qian B, Wei ZR, Li L, Wang XC, Kong ZX. Double contrast-enhanced two-dimensional and three-dimensional ultrasonography for evaluation of gastric lesions. World J Gastroenterol 2012; 18:4136-44. [PMID: 22919245 PMCID: PMC3422793 DOI: 10.3748/wjg.v18.i31.4136] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2011] [Revised: 02/10/2012] [Accepted: 04/09/2012] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the value of two-dimensional (2D) and three-dimensional (3D) double contrast-enhanced ultrasonography (DCUS) imaging for evaluation of gastric lesions.
METHODS: 2D and 3D DCUS imaging with both oral and intravenous administrations of contrast agents was used to assess gastroscopiclly-confirmed gastric lesions in 46 patients with benign and malignant diseases. Initially, liquid-based ultrasound contrast agent (Xinzhang®) was given orally at dose of 500-600 mL for conventional ultrasound examination of the gastric lesions, and then a microbubble-based contrast agent (SonoVue) was injected intravenously at dose of 1.2-2.4 mL in bolus fashion to assess the perfusion pattern of the lesions using contrast imaging modes. The parameters derived from time-intensity curves including the arrival time (AT), time to peak (TTP), peak intensity (PI) and enhanced intensity (EI) were measured on the 2D DCUS imaging. 3D DCUS of the lesions was acquired to demonstrate the value of this imaging mode.
RESULTS: There were 22 cases with benign lesions including chronic gastritis (n = 5), gastric ulcer (n = 9), gastric polyps (n = 3), gastric stromal tumors (n = 5), and 24 cases with malignant lesions including gastric cancer (n = 20), gastric cardia carcinoma (n = 3) and post-operative recurrent gastric cancer (n = 1) in the study. The oral contrast-enhanced ultrasonography (CEUS) imaging of the stomach clearly demonstrated the anatomy of the stomach and morphologic features of gastric lesions. With optimal scanning window and imaging display under oral CEUS, intravenous CEUS clearly showed the perfusion of gastric lesions with various characteristic manifestations. Both 2D and 3D DCUS images clearly demonstrated normal gastric wall as a three-layer structure, from the inside out, hyperechoic mucosa, hypoechoic muscularis and hyperechoic serosa, respectively. There were statistical significant differences of AT (8.68 ± 2.06 vs 10.43 ± 2.75, P = 0.017), PI (34.64 ± 6.63 vs 29.58 ± 8.22, P = 0.023) and EI (29.72 ± 6.69 vs 22.66 ± 7.01, P = 0.001) between malignant lesions and normal gastric wall. However, no differences of AT, PI and EI between benign lesions and normal gastric wall tissue were found. 3D DCUS could intuitively display morphological features and vascularities of the lesions with multiplanar and volume views. 3D DCUS imaging provided comprehensive information complementary to 2D imaging. The crater or wellhead appearances and feeding vessels as well as distorted nourishing vasculature of gastric carcinoma were better seen with 3D imaging than 2D imaging.
CONCLUSION: DCUS imaging can simultaneously display the anatomic and perfusion features of gastric lesions. 3D DCUS can provide additional information to 2D DCUS for evaluation of gastric lesions.
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Zhuang H, Yang ZG, Chen HJ, Peng YL, Li L. Time-intensity curve parameters in colorectal tumours measured using double contrast-enhanced ultrasound: correlations with tumour angiogenesis. Colorectal Dis 2012; 14:181-7. [PMID: 21689263 DOI: 10.1111/j.1463-1318.2011.02546.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
AIM The aim of the study was to assess the correlation between time-intensity curve (TIC) parameters and colorectal tumour angiogenesis using double contrast-enhanced ultrasound (DCEUS), in which an intraluminal contrast agent was used in combination with an intravascular contrast agent. METHOD Thirty nine patients with colorectal tumours were examined preoperatively. During hydrocolonal examination with the intraluminal contrast agent, an intravascular contrast agent, SonoVue, was used to perform the DCEUS. The parameter arrival time (AT), time to peak (TTP), peak intensity (PI) and area under the curve (AUC) were measured. Postoperative specimens were assessed for microvessel density (MVD) and vascular endothelial growth factor (VEGF). The correlation between TIC parameters and the expression of VEGF or MVD was studied. RESULTS The mean values of AT, TTP, PI and AUC of the colorectal tumours were 14.32 ± 11.36 s, 30.61 ± 18.65 s, 20.38 ± 17.45 dB and 221.10 ± 156.09 dB.s, respectively. Both AUC and MVD were significantly higher in colorectal adenocarcinomas than in adenomas (all P < 0.05). A positive linear correlation was found between the AUC and MVD in colorectal tumours (r = 0.686, P = 0.0019). No correlation was found between VEGF and any TIC parameter. CONCLUSION DCEUS is a valuable method for evaluating angiogenesis in colorectal tumours in vivo. The AUC has a positive linear correlation with MVD and could form a new index for assessing angiogenesis and the biological behaviour of colorectal tumours.
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Affiliation(s)
- H Zhuang
- Department of Ultrasound, West China Hospital of Sichuan University, Chengdu, Sichuan, China
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Diana A, Specchi S, Baron Toaldo M, Chiocchetti R, Laghi A, Cipone M. Contrast-enhanced ultrasonography of the small bowel in healthy cats. Vet Radiol Ultrasound 2011; 52:555-9. [PMID: 21689198 PMCID: PMC7169303 DOI: 10.1111/j.1740-8261.2011.01829.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2010] [Accepted: 04/05/2011] [Indexed: 11/30/2022] Open
Abstract
We characterized the pattern of ultrasonographic contrast enhancement of the small intestinal wall using a commercial contrast medium (Sonovue(®) ) in 10 healthy awake cats. Subjectively, a rapid intense enhancement of the serosal and submucosal layers was followed by gradual enhancement of the entire wall section during the early phase. At peak enhancement, there was a subjective loss of demarcation between intestinal wall layers. In the late phase, there was a gradual wash out of signal from the intestinal wall. Submucosal wash out occurred last. Time-intensity curves were generated for selected regions in the intestinal wall and multiple perfusion parameters were calculated for each cat. Perfusion parameters included arrival time (7.64 ± 2.23 s), baseline intensity (1.04 ± 0.04 a.u.), time to peak from injection (10.74 ± 2.08 s), time to peak from initial rise (3.1 ± 1.15), peak intensity (8.92 ± 3.72 a.u.), wash-in rate (2.06 ± 0.70 a.u./s) and wash-out rate (-1.07 ± 0.91 a.u./s). The perfusion pattern of normal feline small bowel may be useful for characterizing feline gastrointestinal disorders that involve the intestinal wall.
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Affiliation(s)
- Alessia Diana
- Department of Veterinary Medical Science, University of Bologna, Bologna, Italy.
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Double contrast-enhanced ultrasonography for the preoperative evaluation of gastric cancer: a comparison to endoscopic ultrasonography with respect to histopathology. Am J Surg 2011; 202:605-11. [PMID: 21824594 DOI: 10.1016/j.amjsurg.2010.09.033] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2009] [Revised: 09/09/2010] [Accepted: 09/09/2010] [Indexed: 01/04/2023]
Abstract
BACKGROUND This study was designed to compare the accuracy of endoscopic ultrasound (EUS) with double contrast-enhanced ultrasound (DCUS) in the staging of gastric malignancies. DCUS is a transabdominal ultrasound technique using both intravenous and intraluminal contrast to enhance sonographic visualization. METHODS This retrospective study included 162 patients with biopsy-proven gastric cancer who underwent DCUS and EUS preoperatively with the ultrasound results compared with the pathologic findings of the resected specimens. RESULTS The overall accuracy of DCUS and EUS for tumor (T) staging was 77.2% and 74.7%, respectively. Comparison of ultrasound techniques for T staging revealed that DCUS was superior to EUS only for a tumor depth of T3 (chi-square, P = .025). Lymph nodes were staged correctly with DCUS and EUS in 78.4% and 57.4% of cases, respectively (chi-square, P = .001). CONCLUSIONS DCUS offers a noninvasive approach for the staging of gastric cancer. DCUS was comparable to EUS in tumor depth evaluation but offered an advantage in lymph node detection.
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Xue N, Huang P, Aronow WS, Wang Z, Nair CK, Zheng Z, Shen X, Yin Y, Huang F, Cosgrove D. Predicting lymph node status in patients with early gastric carcinoma using double contrast-enhanced ultrasonography. Arch Med Sci 2011; 7:457-64. [PMID: 22295029 PMCID: PMC3258739 DOI: 10.5114/aoms.2011.23412] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2010] [Revised: 05/29/2010] [Accepted: 05/31/2010] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Double contrast-enhanced ultrasonography (DCUS) is a new method we used in predicting lymph node metastasis (LNM) in patients with early gastric cancer. MATERIAL AND METHODS Seventy-six patients with early gastric cancer diagnosed by gastroscope and confirmed by pathology after operation were examined using DCUS preoperatively. Group N1 included 15 patients with LNM and group N0 61 patients without LNM. RESULTS In group N1, 13 patients (87%) had marked hyperenhancement during early arterial phase using DCUS, and 2 patients (13%) were unmarked as hyperenhancement. In group N0, 24 patients (39%) had marked hyperenhancement during early arterial phase using DCUS, and 37 patients (61%) had unmarked hyperenhancement. The sensitivity and specificity of marked hyperenhancement in predicting LNM in patients with early gastric cancer was 86.7% and 60.7% respectively, and the Youden's index was 0.474. The κ value of this method was 0.89. CONCLUSIONS Double contrast-enhanced ultrasonography is a new valuable method to evaluate LNM at an early stage of gastric cancer and prognosis of early gastric cancer preoperatively.
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Affiliation(s)
- Nianyu Xue
- 2 Affiliated Hospital of Wenzhou Medical College, Zhejiang, China
| | - Pintong Huang
- 2 Affiliated Hospital of Wenzhou Medical College, Zhejiang, China
| | | | - Zongmin Wang
- 2 Affiliated Hospital of Wenzhou Medical College, Zhejiang, China
| | | | - Zhiqiang Zheng
- 2 Affiliated Hospital of Wenzhou Medical College, Zhejiang, China
| | - Xuedong Shen
- Cardiac Center of Creighton University, Omaha, NE, USA
| | - Yimei Yin
- 2 Affiliated Hospital of Wenzhou Medical College, Zhejiang, China
| | - Fuguang Huang
- 2 Affiliated Hospital of Wenzhou Medical College, Zhejiang, China
| | - David Cosgrove
- Imaging Sciences Department, Imperial College, Hammersmith Hospital, London, United Kingdom
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Jiang J, Chen Y, Zhu Y, Yao X, Qi J. Contrast-enhanced ultrasonography for the detection and characterization of prostate cancer: correlation with microvessel density and Gleason score. Clin Radiol 2011; 66:732-7. [PMID: 21524418 DOI: 10.1016/j.crad.2011.02.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2010] [Revised: 02/09/2011] [Accepted: 02/21/2011] [Indexed: 12/26/2022]
Abstract
AIM To determine whether there is a correlation between the peak intensity of the lesion at contrast-enhanced ultrasonography and the microvessel density (MVD) and Gleason score in biopsy specimens of prostate cancer. MATERIALS AND METHODS Contrast-enhanced ultrasonography using cadence-contrast pulse sequence (CPS) technology was performed in 147 patients with suspected prostate cancer before biopsy. An auto-tracking contrast quantification (ACQ) software was used to analyse the peak intensity (PI) of the lesion. The Gleason score and MVD immunoreactivity were determined in the prostate biopsy specimens. Ultrasound findings were correlated with biopsy findings. RESULTS Prostate cancer was detected in 73 of 147 patients. The PI values of prostate cancer patients were significantly higher than those of non-malignant patients [9.81 (4.23) versus 5.69 (3.19) dB; p<0.01]. The mean (SD) PIs of prostate cancer lesions with a Gleason score of 6-9 were 7.08 (3.80), 8.65 (4.08), 9.76 (3.75), and 9.85 (4.13) dB, respectively. The PI value increased significantly with a higher Gleason score (p<0.01). The mean (SD) MVDs observed in prostate cancer lesions with a Gleason score of 6-9 were 52.50 (10.54), 56.85 (10.31), 59.91 (9.29), and 66.04 (11.82), respectively. There was a positive correlation between PI and MVD in prostate cancer, with a correlation coefficient of 0.617. No correlation was found between PI value and age, prostate specific antigen (PSA) or prostate specific antigen density (PSAD) level (p>0.05). CONCLUSION The PI obtained by CPS harmonic ultrasonography appears to be of value as an indicator of MVD and increases with a higher Gleason score. CPS harmonic ultrasonography could be promising as a useful imaging technique in the detection and characterization of prostate cancer.
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Affiliation(s)
- J Jiang
- Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai 200092, China
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Zhang Q, Yang H, Kang SJ, Wang Y, Wang GD, Coulthard T, Grossniklaus HE. In vivo high-frequency, contrast-enhanced ultrasonography of uveal melanoma in mice: imaging features and histopathologic correlations. Invest Ophthalmol Vis Sci 2011; 52:2662-8. [PMID: 21245408 DOI: 10.1167/iovs.10-6794] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
PURPOSE To evaluate the usefulness of in vivo imaging of uveal melanoma in mice using high-frequency contrast-enhanced ultrasound (HF-CE-US) with 2D or 3D modes and to correlate the sonographic findings with histopathologic characteristics. METHODS Fourteen 12-week-old C57BL6 mice were inoculated into their right eyes with aliquots of 5 × 10(5)/2.5 μL B16LS9 melanoma cells and were randomly assigned to either of two groups. At 7 days after inoculation, tumor-bearing eyes in group 1 (n = 8) were imaged using HF-CE-US to determine the 2D tumor size and relative blood volume; eyes in group 2 (n = 6) were imaged by 3D microbubble contrast-enhanced ultrasound, and the tumor volume was determined. Histologic tumor burden was quantified in enucleated eyes by image processing software, and microvascular density was determined by counting von Willebrand factor-positive vascular channels. Ultrasound images were evaluated and compared with histopathologic findings. RESULTS Using HF-CE-US, melanomas were visualized as relatively hyperechoic regions. The intraobserver variability of sonographic measurements was 9.65% ± 7.89%, and the coefficient of variation for multiple measurements was 7.33% ± 5.71%. The correlation coefficient of sonographic volume or size and histologic area was 0.71 (P = 0.11) and 0.79 (P = 0.32). The relative blood volume within the tumor demonstrated sonographically correlated significantly with histologic tumor vascularity (r = 0.83; P < 0.001). CONCLUSIONS There was a positive linear correlation between sonographic tumor measurements and histologic tumor burden in the mouse ocular melanoma model. Contrast-enhanced intensity corresponded with microvascular density and blood volume. HF-CE-US is a real-time, noninvasive, reliable method for in vivo evaluation of experimental intraocular melanoma tumor area and relative blood volume.
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Affiliation(s)
- Qing Zhang
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia 30322, USA
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Huang P, Li S, Aronow WS, Wang Z, Nair CK, Xue N, Shen X, Chen C, Cosgrove D. Double contrast-enhanced ultrasonography evaluation of preoperative Lauren classification of advanced gastric carcinoma. Arch Med Sci 2011; 7:287-93. [PMID: 22291769 PMCID: PMC3258721 DOI: 10.5114/aoms.2011.22080] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2010] [Revised: 03/28/2010] [Accepted: 05/16/2010] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION The clinical value of double contrast-enhanced ultrasonography (DCUS) in determining the Lauren classification of advanced gastric carcinoma needed investigation. MATERIAL AND METHODS Fifty-eight patients with gastric cancer proved by endoscopic biopsy underwent preoperative DCUS examination in which an oral contrast agent was combined with an intravenous agent, and the findings were compared with the postoperative pathological findings using haematoxylin-eosin and Alcian Blue-Periodic Acid Schiff (AB-PAS) staining. RESULTS Of 58 patients, 34 (59%) were the intestinal type and 24 (41%) the diffuse type on pathological examination of resected specimens. Among intestinal type patients, 30 (88%) showed homogeneous vascular enhancement and 4 (12%) heterogeneous enhancement with the "sandwich" pattern in 2 patients (50%) and "barrier" pattern in 2 patients (50%). In the diffuse type, 22 of 24 patients (92%) enhanced heterogeneously, with stippled and peripheral enhancement in 9 (41%), the "sandwich" pattern in 8 (36%) and "barrier" pattern in 5 (23%). Two of 24 patients (8%) with the diffuse type enhanced homogeneously. The proportion of heterogeneous enhancement was significantly different between the 2 subtypes of tumour (p = 0.0001). The sensitivity and specificity of heterogeneous enhancement in diagnosing the diffuse type of advanced gastric cancer were 92% and 88%, respectively. Youden's index was 0.8. CONCLUSIONS Double contrast-enhanced ultrasonography is a new and useful method to determine Lauren classification in patients with gastric carcinoma.
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Affiliation(s)
- Pintong Huang
- Department of Ultrasonography, the 2 Affiliated Hospital of Zhejiang University, Zhejiang, China
| | - Shiyan Li
- Department of Ultrasonography, the 2 Affiliated Hospital of Zhejiang University, Zhejiang, China
| | | | - Zongmin Wang
- Department of Ultrasonography, the 2 Affiliated Hospital of Zhejiang University, Zhejiang, China
| | | | - Nianyu Xue
- Department of Ultrasonography, the 2 Affiliated Hospital of Zhejiang University, Zhejiang, China
| | - Xuedong Shen
- Cardiac Center of Creighton University, Omaha, USA
| | - Chengchun Chen
- Department of Ultrasonography, the 2 Affiliated Hospital of Zhejiang University, Zhejiang, China
| | - David Cosgrove
- Imaging Sciences Department, Imperial College, Hammersmith Hospital, London, United Kingdom
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Salvatore V, Borghi A, Sagrini E, Galassi M, Gianstefani A, Bolondi L, Piscaglia F. Quantification of enhancement of focal liver lesions during contrast-enhanced ultrasound (CEUS). Analysis of ten selected frames is more simple but as reliable as the analysis of the entire loop for most parameters. Eur J Radiol 2011; 81:709-13. [PMID: 21345634 DOI: 10.1016/j.ejrad.2011.01.097] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2010] [Revised: 01/27/2011] [Accepted: 01/28/2011] [Indexed: 01/13/2023]
Abstract
The aim of the study was to evaluate the reliability of the analysis of only 10 frames rather than of a whole clip in performing quantitative assessment of tumor enhancement of focal liver lesions (FLLs) following ultrasound contrast injection. Contrast-enhanced ultrasonography (CEUS) examinations of 31 FLLs (median diameter: 30mm) were performed. All clips were analyzed and quantified with an early prototype of the SonoLiver software (TomTec GmbH, Munich and Bracco Research SA, Geneva), first evaluating the entire clip then selecting only 10 frames at different time intervals. Enhancement measurements obtained from the analysis of the entire clip or of only 10 frames were closely correlated (r=0.931 and p<0.0001 for Area Under the Curve; r=0.944 and p<0.0001 for Perfusion Index). In conclusion, enhancement quantification of FLLs can be reliably obtained from only 10 frames, rather than the entire clip, at least for most parameters, making such procedure easier for potential routine use.
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Affiliation(s)
- Veronica Salvatore
- Dept. Clinical Medicine - S. Orsola-Malpighi University and General Hospital, Via Albertoni 15, 40138, Bologna, Italy
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Zhuang H, Yang ZG, Wang ZQ, Wang XD, Chen HJ, Zhang YC, Luo Y. Features of time-intensity curve parameters of colorectal adenocarcinomas evaluated by double-contrast enhanced ultrasonography: initial observation. Eur J Radiol 2011; 81:677-82. [PMID: 21316889 DOI: 10.1016/j.ejrad.2011.01.075] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2010] [Revised: 01/16/2011] [Accepted: 01/17/2011] [Indexed: 02/05/2023]
Abstract
PURPOSE This study is to investigate the value of double contrast-enhanced ultrasonography (DCEU) in assessing microcirculation of colorectal adenocarcinomas and to describe the perfusion features of the tumours. MATERIAL AND METHODS DCEUS was performed in 42 patients with adenocarcinoma. The time-intensity curve parameters (arrival time (AT), time-to-peak (TTP), peak intensity (PI) and area under the curve (AUC)) within the tumours were extracted. The parameters were compared among the tumours with different CEUS features and stages. RESULTS The mean values of AT, TTP, PI and AUC of the colorectal adenocarcinomas were 13.68±13.36s, 32.61±19.56s, 19.82±16.54dB and 271.10±159.19dBs, respectively. In the adenocarcinomas with necrosis, the mean values of AUC was significantly lower than that of the adenocarcinomas without (231.10±219.27dBs, 278.10±123.20dBs, p=0.004). In the adenocarcinomas with necrosis, the AUC and PI of the non-necrotic part were significantly higher than that of the necrotic part (p=0.007, 0.0025, respectively). AUC increased progressively in the subgroups of T2, T3 and T4 and the difference of AUC between T2 and T4 subgroup was significant (p=0.008). CONCLUSIONS Double contrast-enhanced ultrasonography is a valuable technique for quantifying tumour vascularity of colorectal adenocarcinomas. AUC was significantly different in the subgroups of different T stage. AUC and PI could reflect the different perfusion status of tumours with or without necrosis.
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Affiliation(s)
- Hua Zhuang
- Department of Ultrasound, West China Hospital of Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan 610041, China
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Liu DM, Huang LP, Zhang HY, Chen YC. Correlation between intensity of ultrasonographic contrast enhancement and microvessel density in gastric cancer. Shijie Huaren Xiaohua Zazhi 2010; 18:2109-2113. [DOI: 10.11569/wcjd.v18.i20.2109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the correlation between the enhanced intensity (EI) revealed by contrast-enhanced ultrasonography (CEUS) and microvessel density (MVD) in gastric cancer.
METHODS: Thirty-seven patients who had pathologically confirmed gastric cancer and underwent CEUS were enrolled in this study. Parameters of the time-intensity curve (TIC), including peak intensity (PI) and basic intensity (BI) of gastric cancer and normal gastric wall, were analyzed. EI (EI = PI - BI) was then calculated. Immunohistochemical staining for CD34 was performed to evaluate MVD. The correlation between EI and MVD was then analyzed.
RESULTS: The EI in gastric cancer lesions was significantly higher than that in normal gastric wall (19.46 ± 5.97 vs 14.25 ± 2.55, P < 0.01). The MVD in gastric cancer lesions was also significantly higher than that in normal gastric wall (84.68 ± 37.99 vs 21.09 ± 5.49, P < 0.01). There was a positive linear correlation between EI and MVD in gastric cancer lesions (r = 0.77, P < 0.01).
CONCLUSION: EI is positively correlated with MVD in patients with gastric cancer. CEUS may be used for assessing the angiogenesis, biological behavior and prognosis of gastric cancer.
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Non-invasive imaging of angiogenesis in head and neck squamous cell carcinoma. Angiogenesis 2010; 13:149-60. [PMID: 20383743 DOI: 10.1007/s10456-010-9167-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2010] [Accepted: 04/01/2010] [Indexed: 12/11/2022]
Abstract
Squamous cell carcinoma of the head and neck (HNSCC) is the seventh most common cancer in the United States. Angiogenesis, the process by which new blood vessels are formed, is an essential element at the basis of both tumor growth and metastases. This review discusses pertinent aspects of the role of imaging modalities in assessing angiogenesis and anti-angiogenic therapy in advanced HNSCC.
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